Eating Disorder Professional Treatment - Group Therapy

As a part of a treatment program, or in conjunction with outpatient individual therapy, you may attend group therapy. Group therapy is an excellent source of treatment and support for bulimic individuals and binge eaters, but has not been as successful for helping those with anorexia. This has been attributed to the highly competitive nature and distrust of anorexics. When in a group format, they tend to compare themselves to other group members and compete to be the thinnest.

There are a great deal of benefits from group therapy, including provision of education, normalizing (group members learn that they are not alone in their disease), support and acceptance (group members learn compassion and empathy for themselves and others), interpersonal skills and friendship, and confrontation of unhealthy behaviors. Groups may be homogeneous, where all members have the same eating disorder, or heterogeneous (members have any type of eating disorder). A heterogeneous group typically includes anorexics and bulimics as they are more similar to each other than to binge eaters. Furthermore, anorexics and bulimics share similar etiology, or causes, for their disordered behaviors. Also, anorexics do better in mixed groups because they feel less threatened when comparing themselves to more average-weight bulimics.

Peer Support Groups

Another group that may be ideal for binge eaters is a support group called Overeaters Anonymous (OA). OA is based on a disease or addiction model of treatment, sometimes referred to as the abstinence model, and parallels Alcoholics Anonymous. OA members learn to comply with the Twelve Steps, and food is viewed as a drug over which those with eating disorders are powerless. The use of an addiction model for treating eating disorders is controversial in the medical literature, and The American Psychiatric Association does not recommend this type of program as the sole treatment approach for anorexia nervosa or bulimia nervosa (recommending it only as a possible complement to other therapies). Critics of this approach suggest that there is little scientific proof that people can become addicted to certain foods; that an addiction model in which bulimics and anorexics can never be fully recovered exacerbates cognitive distortions and self-fulfilling prophecies; that promoting the abstinence of food can clearly backfire in the treatment of anorexics; and that there are too many variations in the quality of services from chapter to chapter. In light of such important criticisms, participation in OA should be viewed as a type of support group rather than as a treatment per se, and undertaken on an as-benefits basis. If such a program proves helpful, it should be continued, and if it seems to make things worse then participation should be discontinued.